Table 3. Limitations of the use of the HAS-BLED score.

Item	Definition	Limitations
Hypertension	“Uncontrolled hypertension >160 mm Hg systolic”	Modifiable by blood pressure control, with consequent score reduction
Abnormal renal/ liver function	“Chronic dialysis, renal transplantation, or serum creatinine (2.26 mg/dL)” & “Chronic hepatic disease (e.g., cirrhosis) or biochemical derangement (e.g., bilirubin >2x AND AST/ALT/AP >3x Upper Limits of Normal”	Potentially modifiable, with consequent score reduction
Stroke	“Previous history, particularly lacunar”	Unmodifiable
Bleeding history or predisposition	“Prior Major Bleeding (i.e., any bleeding requiring hospitalization, reducing hemoglobin by > 2 g/L, or transfusion but NOT Hemorrhagic Stroke) or Anemia”	Commonly scored incorrectly based on prior hemorrhagic stroke
Labile international normalized ratios	“Therapeutic time in range <60%”	Modifiable, with consequent score reduction, and not applicable to direct oral anticoagulants
Elderly	“>65 years”	Arbitrary
Drugs / Alcohol	“Antiplatelet agents or NSAIDs” or “≥8 Units ETOH consumption per week” or both	Modifiable, with consequent score reduction

AST/ALT/AP, aspartate aminotransferase / alanine aminotransferase / alkaline phosphatase; ETOH, ethanol alcohol; HAS-BLED,hypertension, abnormal renal and liver function, stroke, bleeding, labile international normalized ratios, elderly, and drugs or alcohol; NSAID, non-steroidal anti-inflammatory drug.